Green kiwi may improve GI symptoms in IBS-C patients

Habitual intake of green kiwifruit may effectively relieve abdominal pain and constipation in adults with constipation-predominant irritable bowel syndrome (IBS-C), findings from a study presented at DDW 2024 suggest.

“IBS-C and functional constipation have significant negative personal and social impacts. [Hence,] treatment for these conditions is challenging,” noted Jasjot Maggo, PhD, from the Department of Medicine, University of Otago, Christchurch, New Zealand, in the poster presentation at DDW 2024.

There is data to support the potential of green kiwifruit to relieve abdominal discomfort, improve laxation, increase colonic water content, and modulate human gut microbiota composition. [Asia Pac J Clin Nutr 2010;19:451-457; Crit Rev Food Sci Nutr 2018;58:2432-2452; Aliment Pharmacol Ther 2019;49:759-768]

As such, the team sought to assess the effect of consuming green kiwifruit on abdominal pain and the underlying gut physiology. Maggo and colleagues conducted an open-label, negative-controlled, randomized parallel design study comprising 63 adults with IBS-C and functional constipation as per the ROME IV Diagnostic Criteria. Half of the cohort were instructed to consume two green kiwifruit (Actinidia deliciosa ‘Hayward’ 150 g/serving) while the other half consumed calorie-matched maltodextrin (~90 kcal=25 g) daily for 4 weeks. Abdominal pain was assessed using the gastrointestinal symptom rating scale (GSRS). [DDW 2024, poster Mo1938]

Among adults with IBS-C only (n=18), there were significant improvements in the abdominal pain score (p=0.02) and constipation score (p=0.03) in the GSRS.

In adults with both functional constipation and IBS-C (n=57), there was no significant difference in the abdominal pain score, but there was a trend towards improvement in the constipation score (p=0.07).

Apart from the GSRS improvements observed, there was a significant increase in transverse relaxation time of the ascending colon (p=0.02) which, according to Maggo, signifies increased water content in the colonic digesta.

There was also a significant difference in the Irritable Bowel Syndrome – Quality of Life survey between patients who consumed green kiwifruit and those who did not (mean difference, 5.2; p=0.05).

No significant differences were observed in the other patient-reported outcomes evaluated, such as the gastrointestinal domain of the Patient-Reported Outcomes Measurement Information System (p=0.3, p=0.09, and p=0.4 for belly pain, constipation, and disrupted swallowing, respectively) and Bowel Data (p=0.46 and p=0.07 for total bowel movement and complete spontaneous bowel movement, respectively).

Clinically relevant impact

“[Taken together,] this study provides further evidence that habitual consumption of green kiwifruit has a clinically relevant impact on complete spontaneous bowel movements and constipation symptoms,” said Maggo.

The study also showed that consumption of green kiwifruit for a month can influence colonic water content, which might explain for the gastrointestinal improvement that the fruit delivers, she added.

High-quality randomized controlled trials with sufficient power are warranted to further evaluate the impact of green kiwifruit intake on physiological parameters in adults with functional constipation and IBS-C, and to better understand the underlying mechanism of action of green kiwifruit on gut function.